10 Expert Tips To Prevent Runner’s Knee Pain

Prevention is better than cure – so adhering to the advice of rehabilitation specialist, Dan Dyson, will ensure your knees are "happy" and healthy ...

The beginning of each year is the most likely time to pick up injuries due to our increase in activity after the Christmas slump.

Some of us like to pick up where we left off by going out for a run (even though the last time we actually ran was months or even years ago!).

The London Marathon held in the spring, means there are plenty of runners pushing the miles up too quickly, and this combined with adverse weather conditions, can be dangerous.

One of the most common knee problems is “runner's knee” (patellofemoral pain syndrome or the Latin name of "chondromalacia patella") where pain radiates down the front and possibly the side of the knee, due the patella (kneecap) being pulled outwards (laterally).

Often occurring in individuals who have just started exercise, returning from time off or even over use. The kneecap comes away from its normal alignment and the back of the kneecap is aggravated by rubbing on the thigh bone (femur).

As prevention is always better than a cure, here are my top ten tips to prevent runner's knee:

#1 - Progression

Build up your exercise programmes gradually. Record and measure times and distances so you can look back and carefully plan you next steps.

For example I progress my clients to lunges after they have conquered squats, due to the higher intensity of the lunge.

#2 - Cross-training

Cross-train in the gym. Using a bike and cross-trainers takes the impact and pressure off the knee joint.

#3 - Even pressure

Try to use the legs symmetrically. Chances are we have a dominant leg (the one you kick with) – so share it out. Remember to pull up as well push when you pedal on a bike as this activates the posterior chain of muscles in the leg.

Using the calfs, hamstrings and glutes will all help the function of the quads and therefore the knee itself.

#4 - Hydrotherapy

The pool is great to remove joint pressure but be careful of the breaststroke kick action whilst swimming, as this can be harmful if you have a pre-existing knee injury.

Walking in the water forwards, backwards and sideways is also a great muscle builder.

#5 - Build VMO Strength

The vastus medialis oblique (VMO) is part of the quadriceps muscle just above the knee on the inside, that helps to keep the kneecap aligned.

Strength training in the gym, for example squats, helps to build up the quadriceps (quads). Single leg squats are great exercises to build VMO strength and balance.

Static quad contractions and straight leg lifts (with external rotation of the hip) especially target your VMO. I avoid the leg extension machine with anyone with knee pain or weak quads, this is due to the force going into the knee before the quads can work properly.

#6 - Alignment

Whilst squatting, using the leg press, cycling and even on the cross trainer, the correct alignment is essential. Keep the centre of the knee in line with the second toe throughout the movement.

#7 - Build Gluteal Strength

The clam is an exercise we do in order to build glute strength to complement knee function.

#8 - Hamstring Strength

Don’t neglect your “hammies”, these muscles flex your knee. If they are not strong or powerful enough it can lead to anterior cruciate ligament (ACL) issues.

#9 - Balance

Proprioception is the neurological transfer of information from a body part to the brain and back again; this is developed through balancing exercises. The function of proprioceptors improve in the joints of the lower limbs and the small stabilising muscles in the actual joints develop strength and stability.

Good exercises are standing on one foot, developing to knee bends and squats. Doing the same with the eyes shut (improves confidence and spatial awareness), and/or using a Bosu or air disc, two- footed, all help improve balance.

#10 - Flexibility

Tight quads, hip flexors, hamstrings, calfs and/or glute muscles eventually will lead to pain or the risk of injury.

I always recommend my clients to stretch out after each training session, lying on your back flat on the floor so the spine is in line for glute and hamstring stretches, and on your front for quad stretches.

Using the foam roller, you can release tension that’s built up in your ITB (iliotibial band) down the outside of your thigh and calf, reducing tightness and knots that build up from running.

Massage can also get deep into the muscle to release this tension and it's good to relax and get someone else to do the effort.

Everyone’s injury is different and relative to the individual. I’ve found over the past 13 years of helping injured clients recover from knee injuries that these exercise tips will be useful to help you re-balance your leg.

It’s the imbalances that lead to injury, having a
specialist trainer help you recover quickly and to work out the cause will help you to prevent future problems.

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Dan Dyson

Dan is a rehabilitation specialist and a sport & exercise science graduate with over 13 years’ experience in the fitness industry.
He works closely with top physiotherapists and health professionals across London and Hertfordshire, UK, and has also worked in Australia and USA.
Dan has recovered from knee reconstruction himself and in turn can empathise with the frustration of keeping fit and breaking down the physical and mental barriers that try to stop us.
He coaches to educate people and his clients often include seniors, those suffering from cancer, motor neurone disease, arthritis, osteoporosis, post-spinal surgery and of course, those who have had knee replacement/reconstruction.